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Does age matter? Comparing post‐treatment psychosocial outcomes in young adult and older adult cancer survivors with their cancer‐free peers
Author(s) -
Lang Michael J.,
GieseDavis Janine,
Patton Scott B.,
Campbell David J.T.
Publication year - 2018
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.4490
Subject(s) - medicine , psychosocial , survivorship curve , cancer survivor , young adult , mood , anxiety , distress , cancer , population , mental health , confounding , gerontology , demography , clinical psychology , psychiatry , environmental health , sociology
Abstract Objective Adolescents and young adult cancer survivors (AYA) are a unique subpopulation with high levels of distress and unmet need. To date, studies have not disentangled distress due to developmental life stage from distress due to cancer survivorship. This population‐based study allowed a direct comparison between AYA cancer survivors, older adult (OA) cancer survivors, and their cancer‐free peers. Methods We combined 4 annual cycles of the Canadian Community Health Survey (CCHS, 2007‐2010) to obtain a final sample of 239 316 respondents. We dichotomized the total sample into AYA (15‐39 years, n = 83 770) and OA (40+, n = 155 546). Two standardized questions identified cancer survivors ( n = 14 592). The self‐reported outcomes of interest included self‐perceived health and mental health, and health care professional diagnosed mood and anxiety disorders. We used weighted logistic regression models to examine for associations, including an interaction term to assess for effect modification by age. Results After adjusting for confounders, cancer survivorship in AYAs was strongly associated with higher prevalence of both mood (OR 2.00, 95% CI 1.44‐2.77) and anxiety (OR 2.20, 95% CI 1.70‐2.86) disorders as compared to their cancer‐free peers. OA survivors had a weaker association in the same direction (OR 1.10, 95% CI 1.01‐1.21 and OR 1.15, 95% CI 1.02‐1.30, respectively). AYA cancer survivors reported higher levels of poor self‐perceived mental health than their cancer‐free peers (OR 1.49, 95% CI 1.03‐2.14), while there was no significant difference from cancer‐free peers for OAs (OR 1.03, 95% CI 0.92‐1.15). Conclusions AYA cancer survivors experience a significantly higher risk of psychosocial distress than both their cancer‐free peers and OA survivors.